骨科损伤控制对骨盆骨折伴四肢多发性骨折患者的治疗效果观察

李红桥

【摘要】 目的：觀察骨科损伤控制（DCO）对骨盆骨折伴四肢多发性骨折患者的临床疗效，并分析对患者凝血功能的影响。方法：选取2016年7月-2017年7月本院收治的骨盆骨折伴四肢多发性骨折患者88例。按照随机数字表法将其分为A组和B组，各44例。A组在DCO理念下进行分期治疗，B组采用常规方案治疗。观察两组手术指标、手术效果、并发症及治疗前后的凝血功能指标。结果：A组手术时间、术中出血量、体温恢复及骨痂生成时间均少于B组，比较差异均有统计学意义（P<0.05）；术后7 d，两组PT、APT、TT水平均高于术前，Fib水平均低于术前，且A组PT、APT、TT水平均高于B组，Fib水平低于B组，比较差异均有统计学意义（P<0.05）；B组优良率为81.82%，明显高于B组的63.64%（P<0.05）；A组并发症发生率为6.82%，明显低于A组的20.45%（P<0.05）。结论：基于DCO理念对骨盆伴四肢多发性骨折患者进行分期治疗，骨折复位良好，更利于术后功能恢复，同时能够快速纠正患者的乳酸水平，改善其凝血功能，减少术后并发症，较传统治疗更有优势。

【关键词】 骨盆骨折； 四肢多发性骨折； 骨科损伤控制

Observation of Treatment Effect of Department of Orthopedics Injury Control for the Patients with Pelvic Fracture Complicated with Multiple Fractures of the Extremities/LI Hongqiao.//Medical Innovation of China，2018，15（17）：0-030

【Abstract】 Objective：To observe the clinical effects of department of orthopedics injury control for the patients with pelvic fracture complicated with multiple fractures of the extremities，and to analyze the effect on coagulation function of patients.Method：A total of 88 patients with pelvic fracture complicated with multiple fractures of the extremities admitted to our hospital from July 2016 to July 2017 were selected.According to the random number table method，they were divided into group A and group B，44 cases in each group.Group A was treated by stages according to DCO concept，while group B was treated by routine treatment.The operative index，operative effect，complications and coagulation function before and after treatment between two groups were compared.Result：The operative time，intraoperative blood loss，recovery of body temperature and callus formation time in group A were less than those of group B，the differences were statistically significant（P<0.05）.After operation 7 d，the levels of PT，APT and TT in two groups were all higher than those before operation，the level of Fib was lower than that before operation，and the levels of PT，APT and TT in group A were higher than those of group B，the level of Fib was lower than that of group B，the differences were statistically significant（P<0.05）.The excellent and good rate in group A was 81.82%，which was significantly higher than 63.64% in group B（P<0.05）.The incidence of complications in group A was 6.82%，which was significantly lower than 20.45% in group B（P<0.05）.Conclusion：Based on the DCO concept，the patients with multiple fractures of the extremities of the pelvis are treated by stages，and the fracture reduction is good，it is more beneficial to the recovery of postoperative function，and it can quickly correct the lactic acid level of the patients，improve the coagulation function and reduce the postoperative complications，which is more advantageous than the traditional treatment.